VOL. XXXIV, No.

1 History of Pharmacology and Therapeutics 25

Whereas in bygone days it was customary to al- monstration, education and, in urgent and worthy
low infants to grow naturally with no thought of cases, free treatment.
dietary supervision or immunization measures, in By the addition of Negro graduate nurses in
the last decade, it has been noted that because of Public Health to most County Units, the work of
the above mentioned health consciousness, mothers the rural physician has been simplified immeasur-
are thoroughly conversant with such comparatively ably. Investigations, observations and follow-up
unfamiliar innovations as formulae, vitamin defici- care of indigent cases may be delegated to the
encies and growth ratios. Mothers now expect to efficient care of the County Health Nurse. This
have their babies checked frequently and regularly enables the physician to devote most of his time
for weight gain or loss; they are quick to investi- to the medical aspect of the patient.
gate changes in appetite and quirks in digestive Finally, the scope of this paper would be extend-
processes. ed beyond reason to enumerate all of the specific
While in some instances, there may be irritation instances in which rural practice has been modern-
because of the extra work involved, most rural ized. Suffice it to say, in conclusion, that because of
physicians welcome this improvement. To be re- the agencies hereinbefore mentioned and because
lieved of the routine observation of great numbers of a renaisssance of the personal pride which
of throptic and marasmic infants for which, in should characterize every physician in the knowl-
many of them, there could be no prescribed pro- edge of a job well done, it may be safely said that
cedures to insure beneficial results mainly because the rural physician is no longer the stepchild in
of insufficient knowledge of the mothers to follow the rapidly expanding process of specificity in
them is, in my humble opinion, its own reward. modern practice.
As another weapon against these pathetic pic- This paper is closed with a hope that as further
tures, the County Boards of Health, with the State therapeutic aids are unfolded through continued
Board of Health, have thrown their collective advances in medical research, the rural physician,
weight behind the elimination of contagious and as rapidly as possible, will continue to synchronize
communicable disease and have dedicated them- them to his native armamentarium to the increas-
selves to improved health conditions through de- ing detrimental effect upon disease.

An Epitome of the History of Pharmacology

and Therapeutics
J. A. BONE, M.D., Department of Pharmacology, Meharry Medical College
THROUGH a fortuitous combination of circum- We can never be fully in possession of a science
stances the writer found himsllf invited by until we know the history of its development. This
the voice of conscience to give a brief resume of applies to pharmacology no less than to the phil-
the progress and scope of a science which he be- osophy of the sciences in general. There is no sub-
lieves needs to be stressed to those who are at- ject which has given rise to more rational and
tempting to add a practical knowledge of phar- irrational discussion than pharmacology.
macology to their accomplishments, but who are During the preparation of this paper many im-
appalled by the huge amount of information now portant text books, periodicals, etc., have been
on the subject and a bit confused by it all. So the freely consulted, and in reviewing the progress of
resume follows for what it may be worth to those this most important subject the writer desires to
who may care to read it. express his acknowledgment to the various authors.
26 JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION JANUARY, 1942

"Whatever career you embrace, look up to the Greeks and Romans extolled the antiquity,
an exalted goal, Worship great men and great wisdom and scientific knowledge of the Egyptians.
things. But if work should be the very life Thoth or Hermes was for the Egyptians personifi-
of your life, if the cult for great men and great cation of the priesthood, and signifies according to
things be associated with your every thought, the Egyptian language an assembly of learned men,
that is still not enough. Try to bring into and was considered as a unity. Thoth was the in-
everything you undertake the spirit of Scien- ventor of medicine as a science and an art. Hence,
tific Methods."-Louis Pasteur. the names of individuals were lost in the priest-
To study pharmacology is to study one of the hood and the merit that each had acquired by his
most absorbing, fascinating, and profitable sciences work was turned to profit the sacerdotal company
in the art of medicine. No more fascinating path- and was regarded as that of the titular genius of
way leads from physiology to practical medicine this company.
than by way of pharmacology. As a matter of fact In order that one may judge of the immensity
a properly conducted pharmacological experiment of knowledge gathered by the learned of ancient
is divided into three parts: (1) The preparation Egypt reference should be made to the forty-two
of mind as wvell as materials; (2) The laboratory volumes of the Hermetic collections. The last six
procedure; ( 3 ) The analysis and interpretation of of these volumes were especially devoted to medi-
the results. cine. The first Egyptian physician to be recorded
Through all ages man has sought to cure diseases in history was Imhotep, whose name signifies, "He
by divers methods predominant among which has who cometh in peace." In all nations and primitive
been the use of certain remedies commonly known peoples, the early period of popular medicine was
as drugs. Probably the use of remedies originated followed by the practice of Sacerdotal medicine by
with Adam and Eve in the Garden of Eden when the priests or holy men, in which cures were ac-
man first disobeyed the laws of health. complished through prayer and sacrifices, strange
Many scientists believe the forbidden fruit and often nauseous remedies and suggestions.
which Eve was tempted to eat was probably not an Galen, (131-201 A.D.) should be given full
apple, but some substance deleterious to health. credit for the continuance of the work of Hippo-
When the substance was digested and other dis- crates for there were more difficult and perplexing
turbances inaugurated, the treatment probably fell ideas of medicine which had developed and which
tO the lot of Adam, thus constituting him the first he had to overcome and yet, eighty-five known
physician. Then all mankind descending from him, constituents were catalogued by him. His theories
fell with him in his first great transgression. And held sway in European medicine for fourteen cen-
today there are pain, misery, disease and death; turies.
and there is only one thing left and this has been In the middle ages now began the period of
passed down through the corridors of time and monastic medicine, in which there grew up a be-
that is hope. A hope to find a scientific preventive, lief in the miraculous healing powers of saints and
relief, or a cure to prolong life. holy relics. Medicine was lifted to a somewhat
All phases of folk-ways, folk-lore, folk-medicine higher plane in the Eleventh and Twelfth centuries
and the ancient medicine, have been similar in by the organization of the School of Salerno in
tendency, differing only in unimportant details. Italy. There are many more prominent names we
As a matter of fact, we know very little of the could mention here but we will pass on to the
beginning of these. School of Spagarists which was founded near the
Hippocrates (Fifth Century B.C.) is known as end of the Fourteenth Century and reached its ze-
the father of medicine which comes closest to our nith with Paracelsus (1493-1541) (Swiss), Ver-
present day teachings. However, it is true that salius, (French-German) and Ambrose Pare,
medicine existed as a science and as an art cen- (French). The Spagarists insisted upon the virtue
turies before the advent of Hippocrates. We recall of silver, antimony, arsenic and chemicals in gen-
VOL. XXXIV, No. 1 History of Phatrmacology and Therapeutics 27

eral thus being opposed to Galen, (Greek-Roman, tory and Toxicology of the Water Hemlock," the
130-201 A.D.), and the Galenists who used only first orderly and critical presentation of pharmaco-
organic drugs. logic experiments on a large scale. The work of
Then the period of the Renaissance which rep- Wepfer was followed by that of his pupil, John
resents the beginnings of the revival of learning Jacob Harder of Basle, Switzerland who published
and of individual research. In addition to those in his book, "Apiarium," the result of numerous
previously mentioned, the names of Walter Herman animal experiments with drugs. Other names
Ryff of Strasburg, Andrew Versalius of Brussels, which should be mentioned in the slow evolution
Gabriel Fallopius and Bartholomeo Eustachins are of modern pharmacology are those of Menghine,
outstanding in this period. who in 1785 investigated the action of camphor
Modern times - Total emancipation from all on animals; Felix Fontana, who in 1765 performed
drugs, (therapeutic nihilism), was the next signif- more than four thousand animal experiments with
icant step taken by medicine, with the establish- snake venom; Peter John Andrews Daries, who in
ment of the Vienna School of Gerhard Van 1776 published his thesis "On Atropa Belladonna";
Swienten in 1745. Joseph Skoda, (1805-1881) and William Withering, (1741-1799), English
and others advocated that it was necessary to bury physician, who in 1785 published his monograph,
the accumulated refuse of drug worship, quackery, "Account of Foxglove," which showed the results
and supersitition of the centuries and begin anew. of his experiments with digitalis in the treatment
Another reaction against excessive drugging and of dropsy.
the "gunshot" prescription was the establishment Modern pharmacology was made possible by the
of the School of Homeopathy by Samuel C. F. introduction of improved methods and technique
Hahnemann of Leipsic in 1796. This is a system, in chemistry and physiology early in the Nine-
still popular, founded upon the belief that drugs teenth Century. Frederick W. H. Serturner, (1783-
have the power of curing morbid conditions simi- 1841), of Einback, Germany, studied the chemis-
lar to those it has the power to excite. "Similis try of opium from 1805-1817, and isolated mor-
similibus curantur." They administer drugs in in- phine. He is thus credited with inaugurating the
finitely small doses, in contradistinction to the discovery of alkaloids. His work in this field was
regular school of medicine and the common meth- followed by that of Pelletier and Caventou,
od of treating diseases, which is sometimes known Magendie, and Ladenburg, who isolated the other
as Allopathy. The Eclectic School of Medicine was alkaloids; and by that of Liebig and Wohler,
founded in the United States in 1826, and is still (German), who isolated the first glucosides. The
represented by a number of existing colleges. The work of Magendie was followed by that of the
first "regular" school of medicine in this country great physiologist, Claude Bernard, who discovered
was founded in 1765 by the medical faculty of the the locus and modes of action of several opiates
University of Pennsylvania. and further elaborated on Magendie's experiments
The re-establishment of therapeutics, founded with strychnine.
now upon reason, gradually became an assured The use of remedies for the relief of disease
fact; it being the result of our increasing knowl- was almost entirely empirical up to the latter part
edge of anatomy, histology, physiology, chemistry, of the Nineteenth Century. The first independent
and the pharmacologic action of drugs. Soon fol- pharmacological laboratory is said to have been
lowed the isolation of the active principles of established at Dorpat by Rudolph Bushein in 1856.
drugs, (led by the discovery of morphine in 1805), The science of modern pharmacology may be said
succeeded by animal experimentations, by means to have started on Virchow's conception of cellular
of which modern pharmacology has largely de- pathology and its introduction into medicine in
veloped. 1858. Oswald Schmiedeberg of Strausbury, (1838-
John Jacob Wepfer, (1620-1695), of Scheff- 1921), introduced methods for the study of drugs
hausen, Switzerland, presented in his book, "His- action on isolated organs, and Carl Bing, (1832-
28 JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION JANUARY, 1942

1912), of Bonn, who studied the action of alcohol, We interrupt our procedure here to define the
volatile oils, quinine and arsenicals. Sir Thomas term which we have thus far been discussing
Fraser, (1841-1920), of Edinberg, studied the Pharmacology, (Gr. pharmakon, drug or magic
cardiac action of strophanthus, and Sir Thomas remedy: logos, learning, science or a discourse),
Lauder Brunton, (1844-1916), London, who in- is the term used to include all knowledge of drugs
troduced the nitrates as vasodilators. Since that and their actions. It deals with the origin, the
time, many advances have been made through un- anatomical structure and the chemical composition
tiring efforts of numerous scientists, many of of crude drugs, and also includes the actions and
whom have worked unsung and with little funds uses, which we now generally call pharmaco-ther-
year in and year out, searching the unknown. apeutics, (or applied pharmacology). For conven-
Much is still to be learned but slowly and gradually ience of study, pharmacology may be divided into
drug therapeutics is being placed on a rational the following branches:
basis. We know now that drugs may act either Pharmacodynamics, (Gr. Pharmakon: dynamos,
physically, chemically, or by a combination of both power of action), is the study of the action of
methods. drugs on the living organisms.
However, as a contrast, there are today eighty- Materia Medica, (L. Materia, Material; Medica,
three medical schools that are members of the Medical), treats of the source, constituents, physi-
"Association of American Medical Colleges." cal and chemical characteristics, preparations and
Sixty-two of these medical schools, according to doses of drugs.
the various catologs, have independent depart- Pharmacy, (Gr. Pharmakeia witchcraft, the use
ments of pharmacology. Whereas there are only of all kinds of drugs). Pharmacy is the science and
twenty-one recognized medical schools in the art of preparing and dispensing drugs for medicin-
country whose departments of pharmacology are al use.
being hampered or handicapped by being associ- Chemical Pharmacy employs methods used in
ated or under the control of either the department the isolation of pure chemicals and the manufac-
of physiology or bio-chemistry. The rule in these ture of synthetic products, and includes definite
cases, the head of the department is not a pharma- chemical substances only, as alkaloids, glucosides,
cologist and of course his interest must primarily salts, etc.
be centered on that department about which he Posology, (Gr. Posos, how much, logus, under-
knows more and the result is the department of standing), deals withe science of dosage.
pharmacology is handicapped and the other de- Toxicology, (Gr. toxicon, poison; logos, under-
partment will grow at the expense of the depart- standing), deals with the symptoms, diagnosis,
ment of pharmacology. treatment and detection of poisons.
Rational therapeutics is now on a firm basis Prescription writing: A prescription, (L. pre,
working hand in hand with psycho-therapeutics in before, scribere, to write) is an order written by a
the treatment of disease. The value of suggestion physician for one or more medicinal agents, to-
can no longer be denied. It is a strictly scientific gether with his directions to the pharmacist for
method and is employed by many physicians as their preparation and to the patient for their use.
"the faith in the doctor and medicine" and as "the Therapeutics, (Gr. therapeutikos, healing, cura-
personal influence." tive, alleative of therapeuein, to tend the sick), is
Science in its insatiable curiosity may yet re- the application of the effects of a drug, as deter-
lieve the world of the fate which Pandora invited mined by pharmacology, to the treatment of dis-
when she opened the forbidden box. Her act, it eased conditions, whether in men or animals.
will be remembered, released a thousand ills upon Therapeutics, however, may be empirical or ra-
the world. Though fairy tale logic, they are sup- tional. Empirical therapeutics includes the use of
posed to have lodged ever since stirring up all any measure which experience has shown to be
manner of plague. beneficial but the explanation of which is not
 VOL. XXXIV, No. 1 History of Pharmacology and L herapeutzcs 29

known, example, the use of salicylates in rheuma- SYSTEMICALLY ACTING DRUGS

tism, colchicum in gout or the antipyretics in fever I. Nerve (Neurotropic) Drugs.
temperatures. Rational therapeutics consists in the A. Drugs acting on the Central Nervous
use of drugs whose actions are understood and is System
now often referred to as applied pharmacology or a. Stimulants
pharmaco-therapeutics. 1. Cortical
The teaching of pharmacology has made rapid 2. Medullary
progress and a vast number of new facts and many 3. Vomiting center (emetics)
theories are added to the body of the preclinical 4. Spinal
discipline from year to year. b. Depressants
A satisfactory or generally accepted classification 1. Aliphatic anesthetics
of substances with definite pharmacologic actions 2. Aliphatic hyponotics
has not yet been proposed. Our fundamental 3. Opiates
knowledge of drugs has so many gaps, the mechan- 4. Bromides
ism of action of so many pharmacologic agents is 5. Depressants of the heat cen-
still so little understood that any classification must ters (antipyretics)
be arbitrary or tentative in character. 6. Depressants of the cough
There have been many classifications proposed center and other expectorants
by equally as many outstanding pharmacologists B. Drugs acting on the peripheral nervous
but we will refer to only one since we think it is system
very generally accepted and fits in fine in our work a. Somatic motor nerve ends
here at Meharry. b. Autonomic ganglia
This outline of classification is a modification c. Autonomic motor nerve ends
of the dassifications offered by Sollmann and (parasympathetic and sympathetic)
Cushny and the classification itself was worked out d. Sensory Nerve Ends
at Georgetown University School of Medicine, Under each heading first the stimulants and then
Washington, D. C., by Theodore Koppanyi. the depressants are considered.
The following classification with a few minor II. Muscle (Myotropic) drugs.
changes which will not appear in this paper is the A. Skeletal muscle
one adopted by use here at Meharry: B. Smooth muscle
C. Cardiac muscle
LOCALLY ACTING DRUGS
(A consideration of diuretics follows the discui
I. Drugs modifying inflammatory processes. sion of digitalis).
A. Phlogomimetic drugs (irritants, counter- III. General protoplasmic poisons and specifics,
irritants ) with a discussion of chemotherapy.
B. Antiphogistic drugs. In the preceeding classification the main divi-
a. protectives, demulcents, dusting sions of Cushny's System are thus retained.
powders, emollients. We started out to give you a brief summary of
b. Astringents. the history of pharmacology from the days when
c. Antiseptics. the knowledge of drugs was only empirical, to the
establishment of the first rational knowledge and
II. Drugs acting locally in the alimentary tract. finally to the present day idea as to the teaching of
A. Stomachics this science.
B. Digestive ferments and flavoring agents We trust you have read this brief summary of
C. Evacuants the progress and scope of pharmacology and it has
D. Anthelmintics stimulated you to improve on it and clarify the
30 JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION JANUARY, 1942

many things which I have omitted. You see that son. Much of the information contained in this
much has been done in this science but we also paper is culled from these sources, and the ac-
know that there is much more to be done and the knowledgments of the writer are herewith extend-
motto should be "plus ultra," more beyond. ed to the authors of these excellent works.
Space prohibits further discussion of these
matters. The reader is referred to the "History of REFERENCES
Medicine" by Charles Green Cumston; "The Curi- Theodore Kippanyi, Ph.D., Professor of Pharmacology
ous Lore of Drugs and Medicine," by Charles H. and Materia Medica, Georgetown University School of
LaWell; "The Evolution of Modern Medicine," by Medicine, Washington, D. C. (J. of the Assn. of A. Af.
Sir William Osler; "Dental Pharmacology Materia Col. page 340).
H. A. McGuinan, Ph.D., M.D., Professor of Pharma-
Dentica and Pharmaco-Therapeutics," by William cology and Therapeutics, University of Illinois. (Text-
H. C. McGhee, published by the Blakiston Com- book, Applied Pharmacology) Publishers, C. V. Mosby
pany; "History of Medicine by Fielding H. Garri- Company.

Presidential Address-Cook County Physicians Association*

P. M. SANTOS, M.D., Chicago! Ill.
A T this period when scenes are rapidly shifting Our aim then must be: (1) To well prepare
and world landmarks are crumbling before ourselves scientifically, keep physically fit and
the relentless onslaught of diabolical iconoclast; mentally keen. (2) We must earnestly strive early
when democracy as an institution is being deflor- to acquire a semblance of adequate professional
esced, its principles stifled, and in many instances poise and a becoming sense of sympathy and tact,
supplanted by totalitarian dogmas, religious bigo- as well as a pertinent economic view point. (3)
try, race prejudice, and the capricious views of We must prove as trustworthy in medical prob-
egocentrics and intolerable miscreants, we are lems as in relevant matters or inviolable confi-
compelled to reflect for a moment in order to dences. We must strive to elevate medical practice
orient ourselves before we can wisely decide the to a higher plane. We must struggle to bring the
best way to attack the pressing problems before practice of medicine and the doctors of the present
us today. era into the place once occupied by both in the
Medicine is being hamstrung and efforts are sanctum of society, when men, less worthy, scien-
being made to emasculate if possible, those who tifically but more richly endowed with primitive
choose to practice it. Our problems are so num- sincerity and Avicennean altruism, blazed the trail.
erous that if we are to survive this crisis and It should be evident at all times that we must
through our efforts regain our full professional prepare ourselves to deal with man in his various
stature, we must recognize the following facts: sociological aspects-to be able to reach him and
That while in the act of preparation for the ever retain his interest and loyalty.
intriguing task of achieving financial success The scientific aspect needs no more stressing at
through the practice of medicine, one is liable to times than the spiritual, social or even the moral.
overlook the fundamental principles upon which It is by far much more desirable to appear rightly
every physician's ambition must be predicated if worthy than ostentatiously wealthy. As the moun-
true followers of the Aesculapian faith and worthy tains uprear their solid bastions to the skies so
guardians of the Hippocratic principles and ever must we uprear our knowledge and skill as bas-
binding oath. tions around the homes of men, against the rav-
ages of disease, pestilence, and premature physical
*Inaugural Address-Read before the Cook County decadence. Descartes well said: "If ever the human
Physicians' Association, Annual Banquet, Jan., 1941 race is raised to its highest practical level, intel-